1336161298 NPI number — JOEL PASTRANA

Table of content: HEMLATA MISTRY R.N. LMHC (NPI 1598941593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336161298 NPI number — JOEL PASTRANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOEL PASTRANA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336161298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3583
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00958-0583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-373-9696
Provider Business Mailing Address Fax Number:
787-799-9226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 CARR 862
Provider Second Line Business Practice Location Address:
BO. HATO TEJAS
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-4155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-373-9696
Provider Business Practice Location Address Fax Number:
787-799-9226
Provider Enumeration Date:
07/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PASTRANA
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-373-9696

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  2132CP , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 57586 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 890507 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9580059 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9004785 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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